No apologies were received.

In accordance with the Regulations, Members are invited to declare any personal or prejudicial interests they may have and the nature of those interests in respect of items on this Agenda and/or indicate if Section 106 of the Local Government Finance Act 1992 applies to them.

Councillor Stephenson, Councillor Burkitt and Councillor Brown declared interests in items five and six of the agenda as they were registered patients of the Uppingham Surgery.

To receive any petitions, deputations and questions received from Members of the Public in accordance with the provisions of Procedure Rule 217.

The total time allowed for this item shall be 30 minutes.  Petitions, declarations and questions shall be dealt with in the order in which they are received.  Questions may also be submitted at short notice by giving a written copy to the Committee Administrator 15 minutes before the start of the meeting.

The total time allowed for questions at short notice is 15 minutes out of the total time of 30 minutes.  Any petitions, deputations and questions that have been submitted with prior formal notice will take precedence over questions submitted at short notice.  Any questions that are not considered within the time limit shall receive a written response after the meeting and be the subject of a report to the next meeting.

No petitions, deputations or questions from members of the public had been received.

To consider any questions with notice from Members received in accordance with the provisions of Procedure Rule No 219 and No 219A.

No questions were received from Members.

To receive a report from the East Leicestershire and Rutland Clinical Commissioning Groups.

A public report from the East Leicestershire and Rutland Clinical Commissioning Group (ELR CCG) was received.

The purpose of the report was to provide the Adults and Health Scrutiny Panel with an update on the public consultation being undertaken by Uppingham Surgery on its proposal to close Ketton Branch Surgery.

During his introduction, Mr Barrett confirmed the following:

·         The ELR CCG was required to follow a formal process in decision making pertaining to any contract variation; this could include any boundary changes, a relocation or an application to close a branch surgery. This formal process adhered to NHS England national policies and would be considered through the Primary Care Commissioning Committee (PCCC).

·         As the closure of a branch surgery was a major contract change it was deemed appropriate that a full public consultation over 90 days should be undertaken and this began on 1 February 2018. The consultation took the form of holding drop in sessions, writing to patients and asking them to complete a survey.

·         ELR CCG received a substantial amount of feedback, via correspondence and through the drop-in sessions that were held, that raised concerns about the survey questions and the level of information available about the rationale for the proposed change.

·         As a result of this feedback, the CCG advised the practice to amend the survey questions and extend the consultation period from 1 May to 1 June. Additionally the practice wrote to patients giving them more detailed information about the proposed closure and offering an extra drop in session.

·         Once the consultation period had finished a report would be presented to the PCCC which would take into account information gathered from the consultation, an equalities impact assessment undertaken by both the practice and the CCG and responses from stakeholders which would include any response from Rutland County Council.

·         It was anticipated that a decision would be made by July or August.

During discussion the following points were noted:

·         There was concern that the relationship between the CCG and Uppingham Surgery had been overly close and that rather than imparting advice, the CCG had been led by the practice into influencing public opinion. As an example of this, reference was made to the CCG’s open letter to Ketton ward members that had been sent to the Stamford Mercury and the Rutland Times without any prior consultation with them.

·         The CCG felt that they had been clear that it was the Practice’s plans and their consultation, and that their role had been to advise on the consultation. It was deemed acceptable that a letter could be sent to the press so that information about the business case could be disseminated more widely.

·         Feedback from the first questionnaire had highlighted that issues around transport and accessibility were not able to be fed in. The more detailed, additional questions around transport that were added to the questionnaire would enable the CCG to tease out if there were any mitigating circumstances that needed to be considered. It was felt that the  ...  view the full minutes text for item 740.

To receive a presentation from Uppingham Surgery.

Further information on the Consultation can be found at:

https://www.uppinghamsurgery.nhs.uk/ketton-branch-surgery-could-be-closing/

The Partners and Office managers from Uppingham Surgery outlined the reasons and the rationale behind their proposal to close Ketton branch surgery.

During their presentation, the Surgery confirmed the following points:

·         Uppingham Surgery had 11,000 patients and the Partners wanted to provide the best clinical care to all of these patients whilst operating under some major national and local challenges that included GP recruitment and treating patients across a 100 square mile area.

·         In 2005 it was proposed that the Ketton branch surgery at Geeston should be closed as a result of underutilisation and the building not being fit for purpose. The Parish Council came up with a solution to move the surgery to the Library and the practice were hopeful that this would increase the number of patients and decrease the number of underutilised appointments. Unfortunately there had been a net reduction in the number of patients, down by 17%, and 41% of appointments remained unfilled.

·         Uppingham Surgery was facing the challenge of increasing demand for services whilst ensuring that the resources that they had were utilised effectively.

·         Currently Uppingham Surgery had a 91% satisfaction rate compared with 85% nationally. Their patients liked the Rapid Access Clinic model they offered which meant that they were able to offer appointments on the day and respond to needs immediately. In order to maintain this model, and as they had not been immune to the nationwide GP shortage, Uppingham Surgery had adopted different ways of working using advanced nurse practitioners and clinical pharmacists in a multi-disciplinary approach. This approach had not worked at the Ketton branch which continued with a number of unfilled appointments. A significantly lower percentage of Ketton residents registered with the surgery as compared with other branches.

·         Six different options for the Ketton branch surgery were outlined. Option 1 was to maintain the status quo which would mean a high number of appointments would remain unfilled causing a detrimental effect to other patients. Option 2 was to replace GP sessions with other practice staff but that would limit the breadth of issues that could be dealt with and would lead to even more unfilled appointments. Option 3 was to reduce the GP sessions by half but that had already been attempted and the appointments were still underutilised. Option 4 was to reduce the number of sessions at all branches but there was a significant difference in the number of patients registered, for example, at Gretton. Gretton patient numbers had increased by 38% whilst Ketton patient numbers had decreased by 17%.  Option 5, the preferred option, was to close the Ketton branch surgery. Option 6 was to close all branch surgeries but the demand in Barrowden and Gretton would make it difficult to provide all services. Additionally Uppingham Surgery was the sole occupier of the premises at Gretton and Barrowden. In weighing up all these options Uppingham Surgery had to consider the care of all its patients as it cared passionately about the level of care that it offered and  ...  view the full minutes text for item 741.